Nati-Castillo H A, Aristizabal-Colorado David, López Ordoñez Carolina, Egas Proaño Diego, Ortiz-Prado Esteban, Izquierdo-Condoy Juan S
Grupo Interinstitucional Medicina Interna (GIMI 1), Universidad Libre, 760042, Cali, Colombia.
Hematoncólogos S.A, 760042, City, Colombia.
Int J Cardiol Cardiovasc Risk Prev. 2024 May 31;22:200292. doi: 10.1016/j.ijcrp.2024.200292. eCollection 2024 Sep.
Acute cardiac complications post-chemotherapy is rare. Stress cardiomyopathy, one of these complications, should be considered in differential diagnoses as its symptoms closely resemble those of acute myocardial infarction and can lead to mortality.
The objective of this paper is to describe Takotsubo syndrome (TTS) as an acute complication following combined chemotherapy in a patient with significant thromboembolic burden and metastatic cervical cancer.
A 61-year-old female patient with a diagnosis of metastatic cervical cancer experienced acute chest pain. Elevated troponin levels and abnormalities in the electrocardiogram initially suggested an acute myocardial infarction, occurring after a chemotherapy session involving Carboplatin and Paclitaxel infusion. Although initial treatment targeted myocardial infarction, further diagnostic evaluations including coronary angiography and cardiac magnetic resonance imaging revealed no coronary artery disease but identified features consistent with stress cardiomyopathy, indicative of Takotsubo syndrome (TTS). This diagnosis led to an improvement in symptoms and a resolution of the acute changes observed.
Stress cardiomyopathy, particularly TTS, is being increasingly recognized as an acute complication associated with combined chemotherapy regimens. The potential cardiotoxic effects of these chemotherapy agents demand careful monitoring and evaluation in patients undergoing oncological treatment, underscoring the importance of integrating cardioprotective strategies into the management of these patients.
化疗后急性心脏并发症较为罕见。应激性心肌病是其中一种并发症,在鉴别诊断时应予以考虑,因为其症状与急性心肌梗死极为相似,且可能导致死亡。
本文旨在描述一位患有严重血栓栓塞负担和转移性宫颈癌的患者在联合化疗后发生的应激性心肌病(TTS)这一急性并发症。
一名61岁诊断为转移性宫颈癌的女性患者出现急性胸痛。肌钙蛋白水平升高及心电图异常最初提示急性心肌梗死,发生在一次包含卡铂和紫杉醇输注的化疗疗程之后。尽管初始治疗针对心肌梗死,但包括冠状动脉造影和心脏磁共振成像在内的进一步诊断评估未发现冠状动脉疾病,却发现了与应激性心肌病相符的特征,提示应激性心肌病(TTS)。这一诊断使症状得到改善,所观察到的急性变化也得以缓解。
应激性心肌病,尤其是TTS,越来越被视为与联合化疗方案相关的急性并发症。这些化疗药物的潜在心脏毒性作用要求对接受肿瘤治疗的患者进行仔细监测和评估,凸显了将心脏保护策略纳入这些患者管理的重要性。